MODERN DENTAL PROFESSIONALS UT, PC (NPI# 1265889166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265889166 |
| Entity Type | Organization |
| Organization Name | MODERN DENTAL PROFESSIONALS UT, PC |
| Other Organization Name | MONARCH DENTAL - SOUTH OGDEN |
| Practice Address |
5974 S. Fashion Pointe Drive Suite 210 South Ogden UT 84403 |
| Mailing Address |
8415 Datapoint Drive Suite 1020 San Antonio TX 78229 |
| Practice Telephone | 8015475612 |
| Practice Fax Number | 8016217933 |
| Mailing Telephone | 7145786358 |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2016-05-20 |
| Authorized Official Name | DR. ROBERT CHIDESTER (PC PRESIDENT) |
| Authorized Official Telephone | 7145786358 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | Y |
| Parent Organization Name | MODERN DENTAL PROFESSIONALS UT, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 141895-9921 | UT | Dental Providers |
| Other Name | Type Code |
|---|---|
| Monarch Dental - South Ogden | Doing Business As Name - Organization |
| Street Address |
5974 S. FASHION POINTE DRIVE SUITE 210 |
| City | SOUTH OGDEN |
| State | UT |
| Zip Code | 84403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
| 1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
| 1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
| 1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
| 1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
| 1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
| 1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
| 1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
| 1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
| 1871940361 | Mar Sager Creixell | Pharmacist | 4421 Harrison Blvd Suite A-12, Ogden, UT 84403 | 2016-05-16 |
| Find all providers in zip 84403 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790904217 | Patrick Mcneil Tanner | Dentist | 5856 Harrison Blvd Ste B, South Ogden, UT 84403-4397 | 2007-04-24 |
| 1053419226 | Lindsay Shepard Curtis | Dentist | 5640 Wasatch Dr, Suite A, South Ogden, UT 84403 | 2006-09-20 |
| 1528088580 | Kevin L. Norris | Dentist | 1770 Combe Rd Ste 4, South Ogden, UT 84403-5067 | 2006-07-20 |
| 1326423872 | Taylor Paul Ericksen | Dentist | 5974 Fashion Point Dr, South Ogden, UT 84403 | 2015-07-27 |
| 1023136488 | Jonathan G. Ford | Dentist | 1508 E Skyline Dr, Suite 400, South Ogden, UT 84405-4846 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295335404 | Ida Nourbakhsh | Dentist | 1947 E Redondo Ave, Salt Lake City, UT 84108-3119 | 2020-10-27 |
| 1902410947 | Creek Dental Group Meadowbrook LLC | Dentist | 1148 E Ut-193, Layton, UT 84040 | 2020-09-08 |
| 1689282089 | Nathan Elmer Kobold | Dentist | 188 E 2050 S Apt B4, Bountiful, UT 84010-5456 | 2020-07-21 |
| 1205454113 | Dylan Lane Harmon | Dentist | 1445 N 400 E # 3a, North Logan, UT 84341-7564 | 2020-07-07 |
| 1902420318 | Cory Johnson | Dentist | 170 E Commonwealth Ave, South Salt Lake, UT 84115-2712 | 2020-06-01 |
| 1538783196 | Trevor Garrett | Dentist | 182 Ashe Dr, Brigham City, UT 84302-2788 | 2020-05-29 |
| 1538796818 | Andrew Phillips | Dentist | 2070 S View St Apt 113, Salt Lake City, UT 84105-3766 | 2020-03-25 |
| 1306499249 | Abundant Dental Care, P.C. | Dentist | 5089 West 12600 South, Herriman, UT 84096 | 2019-07-19 |
| 1770135923 | Mcconnell Dental Care IIi | Dentist | 263 Country Clb Ste 102, Stansbury Park, UT 84074-9602 | 2019-07-09 |
| 1700446267 | Michael Wagner | Dentist | 754 S Main St Ste 1, St George, UT 84770-5510 | 2019-06-17 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH OGDEN |
| Zip Code | 84403 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.